Provider Demographics
NPI:1780239590
Name:BURDA, RACHEL SUSAN (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUSAN
Last Name:BURDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 QUEENS PLZ N FL 1010TH
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4020
Mailing Address - Country:US
Mailing Address - Phone:212-283-3000
Mailing Address - Fax:646-665-3604
Practice Address - Street 1:3169 BRAVERTON ST STE 201
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2690
Practice Address - Country:US
Practice Address - Phone:410-956-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216988363LP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY344888OtherLICENSE